If you’re experiencing pain on the outside of your elbow or forearm (towards the thumb side of your arm) dry needling is an excellent therapy to bring you tennis elbow pain relief.

If you haven’t discovered this already, tennis elbow doesn’t only happen in those of us who play tennis! Tennis elbow is just a common “laymen” term for what we in the physical medicine world call lateral epicondylitis, lateral epicondylalgia, or lateral epicondylopathy. This diagnosis means you may be having pain, discomfort, weakness, swelling, or inflammation around the lateral epicondyle (outside part of your elbow.)

In this content, I’ll focus on dry needling for tennis elbow and how it can help.

What Causes Tennis Elbow?

Tennis (Duh!) can certainly cause this condition to develop, but so can other sports and even activities you do in your daily life that aren’t sports related. In athletes (when I saw athletes I mean anyone that exercises frequently) I see this condition in those who are into CrossFit.

I see it just develop just as often in those who aren’t athletes, especially in those with jobs that require a lot of computer and mouse work (which is a lot of people!)

What’s causing the pain in tennis elbow is actually the tendon(s) of the wrist and finger extensor muscles. These are the muscles that lift your finger and wrist up. Thes muscles are really active in the movements you’re doing when typing or using a mouse or gripping anything, for example, a barbell. (That’s your CrossFit people!)

Repetitive movements can cause excess strain on the tendon of the muscle(s) and cause repetitive microtrauma to the tissues. Subsequently, they’re never able to heal correctly and they continue to be traumatized over and over. Over time this results in weakness in the structure of the tendon and it’s not able to accommodate a normal load any longer. This is really a tendon failure injury.


Take a look at this image. This shows common areas of pain caused by trigger points in the arm and shoulder. These trigger points can cause tennis elbow pain, weakness, and loss of function.

Dry Needling for Tennis Elbow

Dry needling for tennis elbow can relieve pain, reduce muscle tightness, and return you back to normal function again. If you’ve tried OTC pain relievers, elbow braces, and stretching (referred to as usual care/first-line treatment) and still have pain, then dry needling is a logical next step for you to try.

Here’s how dry needling can help your tennis elbow:

  1. Dry needling releases myofascial trigger points in the elbow that are affecting the function of your muscles and contributing to your pain.
  2. Dry needling increases microcirculation to the tissues. More blood supply is great for the healing process going on in the tissues of your forearm.
  3. Dry needling stimulates cellular activity around the site of injury and improves the healing process in your extensor tendons.
  4. Dry needling RELIEVES PAIN! Despite the initial soreness, dry needling releases chemical mediators that reduce pain in your elbow.

You can see from the list above that dry needling is not only great at giving you symptomatic relief in your elbow but it also has positive effects on the actual site of injury. This is exactly what you want in treatment, not something that only relieves pain and ignores the tissue damage, but something that’s relieving pain and helping your body heal the area of damaged tissue.


This image shows three common trigger points in tennis elbow. These are called “homeostatic trigger points.” I’ll use some dry needling a the site of pain as well as the area around the spine that innervates this area of the arm (segmental dry needling.) Shown here is dry needling of the superficial radial trigger point, deep radial trigger point, and lateral antebrachial cutaneous trigger point.

Effectiveness of Dry Needling for Tennis Elbow

Dry needling has just recently become a more common treatment in the office of chiropractors, physical therapists, and even medical doctors. Due to its recent popularity, there are a few research studies coming out regarding the effectiveness of dry needling for tennis elbow, but there aren’t a ton of them. Let’s look at the research…

Dry needling in tennis elbow: a prospective controlled study

110 participants who suffered from tennis elbow were divided into two groups randomly. One group had dry needling to treat their tennis elbow and the other group had “first-line treatment.” First-line treatment consisted of 100mg of Ibuprofen twice a day and a counterforce brace.

The researchers followed up with the patients at 3 weeks and 6 months. Both groups had improvement at each follow-up but dry needling gave significantly greater relief of tennis elbow symptoms at 6 months compared to first-line treatment.

Mulligan’s Mobilization with Movement and Muscle Trigger Point Dry Needling for the Management of Chronic Lateral Epicondylalgia: A Case Report

This is a case study about dry needling in a female who had suffered from tennis elbow for 6 years. She had 8 treatments of dry needling over 4 weeks along with some mobilization (gentle joint glides to improve joint motion – chiropractors do this every day.)

After 4 weeks of treatment, the patient’s pain completely disappeared and she was able to grip stronger without pain.

As I said, there’s not a ton of research on dry needling for tennis elbow, but what is out is positive. Research is just part of the clinical decision-making process when I decide how to treat tennis elbow. I also use my clinical experience, and through my clinical experience, the vast majority of tennis elbow cases in my office have responded well to care.

Dry Needling in Cary for Tennis Elbow

Dr. Jason Williams DC uses dry needling for tennis elbow at his Cary chiropractic office. If you’re in Cary, Apex, or Raleigh AccessHealth Chiropractic center is a great choice if you’re wondering “Where can I get dry needling near me?” Let me give you a quick overview of what my appointments are like:

  • After I examine your elbow, I’ll determine if dry needling is the right treatment for your case of tennis elbow.
  • I typically recommend 4-6 visits, this is called a trial of care. I’d expect to see significant improvement or to see your complaint resolved after the trial of care. We use pain, function, and percentage of time it bothers you as progress measures.
  • Not only are you going to get dry needling for tennis elbow discomfort, but I’ll also give you a home exercise program prescription and I might use other treatments such as therapeutic ultrasound, Graston Technique instrument-assisted soft tissue mobilization, and Kinesiotape to help you heal as fast as possible.

I’ve seen enough cases of tennis elbow to know that each case is unique. I also know from experience that most cases will respond very well to dry needling, even when treatments (like physical therapy or cortisone injections) have failed. If you’re considering dry needling to treat tennis elbow pain or have other questions, feel free to check out some of our other blog content or call and ask me.